by Kelly Kennedy, USA TODAY

by Kelly Kennedy, USA TODAY

WASHINGTON - The number of customers on the nation's largest private health insurance exchange increased by 50% in the final three months of 2013, a direct result of demand created by the Affordable Care Act, the company's CEO said Thursday.

Gary Lauer, CEO of eHealth Insurance, said individual memberships rose 50% in the fourth quarter of 2013 compared with the same period in 2012, from 113,600 applications in the last three months of 2012 to 169,800 in 2013.

"The impact of the Affordable Care Act provisions were especially significant in the individual market," Lauer said Thursday afternoon. The opening Oct. 1 of the enrollment period for people to buy health insurance "drove significant demand," he said.

Only 10% of those buying new policies had bought policies from eHealth Insurance in the past, he said. Consumers who grew frustrated with HealthCare.gov may have turned to eHealth when the federal site was down in October, he said.

None of the new eHealth customers came through the state or federal health exchanges, Lauer said.

The company's recent success did not surprise Peter Lee, director of California's state exchange. Lee said potential insurance customers who had waited up to years for the chance to buy insurance starting Oct. 1 would hit private exchanges if they did not qualify for federal help buying insurance.

"We don't care where you get insurance," Lee said, "just get insured."

Because of the new law, several factors have changed how people buy insurance:

‚?ĘThey don't have to pay more for pre-existing conditions, such as diabetes or being female.

‚?ĘThey can't be precluded from buying insurance because of a health issue.

‚?ĘInsurers must lay out their plans in an apples-to-apples format with costs clearly stated.

People may use a private exchange to buy insurance or go directly to an insurer, because there are more options available, said Brian Mast, vice president of communication for eHealth.

The company had more plans available than Covered California, the state exchange, Mast said, as well as plans for health insurer Cigna.

The site operates much like the federal and state exchanges, and now that people have a better understanding of what "exchange" means, they're drawn to the private sites, as well. In fact, many employers offer private exchange coverage, so employees may pick a plan, and many insurers are creating their own private "exchange" sites, so they can offer more products to consumers.

Those shopping on private exchanges might include business owners who make more than 400% of the federal poverty level, but who couldn't get insurance before; retirees who are not eligible for Medicare; or people who simply disagree with the Affordable Care Act and choose to find insurance outside the federal and state exchanges - even if those plans are also through private insurers.

Premium rates, Mast said, dropped 25% when the law went into effect, as more people chose the less expensive bronze-level plans. The company saw the percentage of customers aged 38 and younger decline from 50% to 40%, because more people younger than 26 stayed on their parents' plans and older people with pre-existing health conditions bought insurance.

Mast said the company is working with the Department of Health and Human Services to set up a system for people eligible for subsidies to enroll through eHealth, rather than through the state or federal exchanges. Lauer said they face technical issues.